Formulary Chapter 7: Obstetrics, Gynaecology, and urinary-tract disorders - Full Chapter
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07.01 |
Drugs used in obstetrics |
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07.01.01 |
Prostaglandins and oxytocics |
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Carboprost (Hemabate®)
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Formulary
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Secondary care use only.
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Dinoprostone (Prostin E2®)
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Formulary
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Secondary care use only. Note: Prostin E2 Vaginal Gel and Vaginal Tablets are not bioequivalent.
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Ergometrine Maleate (Ergometrine)
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Formulary
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Secondary care use only.
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Ergometrine Maleate and Oxytocin (Syntometrine®)
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Formulary
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Secondary care use only.
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Oxytocin (Syntocinon®)
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Formulary
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Secondary care use only.
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07.01.01.01 |
Drugs affecting the ductus arteriosus |
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07.01.01.01 |
Maintenance of patency |
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07.01.01.01 |
Closure of ductus arteriosus |
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Ibuprofen (NeoProfen® injection)
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Unlicensed
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Secondary care use in SCBU only.
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Indometacin (Injection)
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Unlicensed
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Secondary care use only for closure of Patent Ductus Arteriosus (PDA) in premature neonates.
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Mifepristone (Mifegyne®)
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Formulary
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Secondary care use only.
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NICE Evidence summary: Mifepristone for induction of labour in late intrauterine fetal death
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07.01.03 |
Myometrial relaxants |
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Salbutamol IV (Obstetrics)
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Formulary
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Secondary care use only.
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Terbutaline (Obstetrics)
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Formulary
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Secondary care use only.
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07.01.04 |
Drugs for preterm labor |
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07.02 |
Treatment of vaginal and vulval conditions |
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07.02.01 |
Preparations for vaginal and vulval changes |
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Oestrogens, Topical (Gynest® 0.01%) (Estriol)
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First Choice
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Vaginal cream for HRT treatment, in line with Oxfordshire HRT formulary and treatment guidance.
APCO January 2016.
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Oestrogens, Topical (Vagifem®)
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First Choice
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First line topical vaginal oestrogen treatment for HRT, in line with Oxfordshire HRT formulary and treatment guidance.
APCO January 2016.
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Oestrogens, Topical (Estring®)
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Second Choice
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Alternative option if allergic to other topical products, dexterity problems with applicators or patient preference, in line with Oxfordshire HRT formulary and treatment guidance.
APCO January 2016.
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Oestrogens, Topical (Ovestin®)
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Formulary
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07.02.01 |
Non-hormonal preparations |
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07.02.02 |
Vaginal and vulval infections |
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07.02.02 |
Fungal infections |
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Clotrimazole (Pessary/ PV cream)
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First Choice
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For the treatment of vaginal candidiasis and trichomoniasis, in line with SCAN guidelines.
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Fluconazole (Oral)
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First Choice
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For the treatment of vaginal candidiasis and recurrent infections, in line with SCAN guidelines.
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UKMI Q&A: Can oral fluconazole be used with breastfeeding?
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Miconazole (Gyno-Daktarin®) (vaginal cream)
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First Choice
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One of first line options for treatment of vaginal candidiasis in non-pregnant women.
First line treatment of vaginal candidiasis in pregnant women, in line with SCAN guidelines.
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07.02.02 |
Other vaginal infections |
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Clindamycin 2% (Dalacin®) (Cream)
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Formulary
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For the treatment of bacterial vaginosis, in line with SCAN guidelines.
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Metronidazole 0.75% (Zidoval®) (Vaginal gel)
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Restricted
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For the treatment of bacterial vaginosis, in line with SCAN guidelines.
Metronidazole is reserved to patients allergic to clindamycin.
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07.03.01 |
Combined hormonal contraceptives |
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Ethinylestradiol 30mcg / levonorgestrel 150mcg (Rigevidon®, Microgynon 30®, Levest®, Ovranette®)
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First Choice
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Monophasic standard strength combined oral contraceptive (21 day preparation). Levest® is the most cost-effective monophasic standard strength (21 day) preparation.
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Ethinylestradiol 35 mcg / noresthisterone 500mcg (Brevinor®)
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First Choice
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Monophasic standard strength (21 day preparation).
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Ethinylestradiol 20mcg / desogestrel 150mcg (Gedarel® 20/150, Alenini®, Mercilon®)
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Second Choice
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Monophasic low strength (21 day preparation). Gedarel® 20/150 is the most cost-effective preparation.
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Ethinylestradiol 20mcg / gestodene 75 mcg (Millinette® 20/75, Femodette®, Juliperla®, Sunya®)
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Third Choice
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Monophasic low strength (21 day preparation). Millinette® 20/75 and Juliperla® are the most cost-effective options.
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Ethinylestradiol 30mcg / desogestrel 150mcg (Gedarel® 30/150, Marvelon®, Cimizt®)
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Third Choice
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Monophasic standard strength (21 day preparation). Gedarel® 30/150 and Cimizt® are more cost-effective than Marvelon®.
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Ethinylestradiol 30mcg / gestodene 75 mcg (Millinette® 30/75, Femodene®,Sofiperla®, Katya®)
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Third Choice
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Monophasic standard strength (21 day preparation). Millinette® 30/75 and Sofiperla® are the most cost-effective options.
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Mestranol 50mcg / norethisterone 1mg (Norinyl-1®)
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Formulary
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Monophasic standard strength (21 day preparation).
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Ethinylestradiol 35 mcg / noresthisterone 1mg (Norimin®)
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Formulary
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Monophasic standard strength (21 day preparation).
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Ethinylestradiol 35 mcg / norgestimate 250 mcg (Cilique®, Cilest®, Lizinna®)
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Formulary
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Monophasic standard strength (21 day preparation).
Cilique® is the most cost-effective option.
Cilest® will be discontinued with effect from July 2019. Current supplies are expected to last until mid-July 2019.
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Combined Hormonal Contraceptives (Logynon ED®)
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Formulary
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Phasic standard strength (28-day ‘Every day’ preparation).
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Combined Hormonal Contraceptives (Synphase®)
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Formulary
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Phasic standard strength (21 day preparation).
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Ethinylestradiol / levonorgestrel phased pill (TriRegol®, Logynon®)
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Formulary
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Phasic standard strength (21 day preparation). TriRegol® is more cost-effective than Logynon®.
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Ethinylestradiol 30mcg / levonorgestrel 150mcg (Microgynon 30 ED®)
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Formulary
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Monophasic standard strength (28-day ‘Every day’ preparation). Microgynon 30 ED® is more cost-effective than Femodene ED®.
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Ethinylestradiol 30mcg/drospirenone 3mg (Yasmin®)
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Restricted
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Restricted use for women who are unable to tolerate alternative combined oral contraceptives. APCO January 2011.
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Combined Hormonal Contraceptives (Evra) (Transdermal patch)
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Restricted
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Evra® patches should be restricted for use in women who are likely to comply poorly with combined oral contraceptives. The Scottish Medicines Consortium (September 2003).
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Combined Hormonal Contraceptives (NuvaRing®)
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Restricted
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Second or third line option contraceptive when other methods have proved unacceptable. APCO July 2009.
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07.03.01 |
Emergency contraception |
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07.03.01.02 |
Co-cyprindiol |
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07.03.01.03 |
Phased formulations – standard dose 30 micogram oestrogen |
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07.03.01.04 |
Low dose oestrogen – 20 microgram ethinylestradiol |
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07.03.01.05 |
Transdermal (standard strength) |
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07.03.01.06 |
Vaginal rings (low strength |
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07.03.01.07 |
Copper intra-uterine devices |
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07.03.02 |
Progestogen-only contraceptives |
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07.03.02.01 |
Oral progestogen-only contraceptives |
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Levonorgestrel 30mcg (Norgeston®) (Oral progestogen-only contraceptive)
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Formulary
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Norethisterone 350mcg (Noriday®) (Oral progestogen-only contraceptive)
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Formulary
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Desogestrel (Oral progestogen-only contraceptive)
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Formulary
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Prescribe generically.
Cerazette is 3.5 times more expensive than generic.
APCO April 2020.
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07.03.02.02 |
Parenteral progestogen-only contraceptives |
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Etonorgestrel (Nexplanon®)
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Formulary
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Provides contraception for up to 3 years. APCO September 2010.
MHRA/CHM advice (June 2016): There have been rare reports of Nexplanon® implants reaching the lung via the pulmonary artery. An implant that cannot be palpated at its insertion site should be located and removed as soon as possible; if unable to locate implant within the arm, the MHRA recommends using chest imaging. Correct subdermal insertion reduces the risk of these events.
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MHRA: Reports of implant device in vasculature and lung
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Medroxyprogesterone Acetate (Depo-Provera®)
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Formulary
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Intramuscular injection.
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Medroxyprogesterone acetate (Sayana Press®)
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Formulary
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Subcutaneous injection.
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07.03.02.03 |
Intra-uterine progestogen-only contraceptive |
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Intra-uterine Progestogen Only System (Levosert®)
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Formulary
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For women requiring contraception for up to 4 years.
NB. Levonorgestrel-releasing intra-uterine devices vary in licensed indication, duration of use and insertion technique—the MHRA recommends to prescribe and dispense by brand name to avoid inadvertent switching.
Heavy Menstrual Bleeding: For women requiring HMB treatment for up to 4 years.
APCO March 2018.
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Intra-uterine Progestogen Only System (Mirena®)
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Formulary
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Contraception: For women requiring contraception for up to 5 years. Levonorgestrel-releasing intra-uterine devices vary in licensed indication, duration of use and insertion technique—the MHRA recommends to prescribe and dispense by brand name to avoid inadvertent switching.
Heavy Menstrual Bleeding: For women requiring HMB treatment for up to 5 years in line with local Care Pathway and Referral Criteria
Adjunctive progestogen in HRT treatment: in line with Oxfordshire HRT formulary and treatment guidance. Licensed for 4 years for HRT use.
APCO January 2016.
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Intra-uterine Progestogen Only System (Jaydess®)
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Restricted
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As an alternative to Levosert/ Mirena if:
- The woman has previously used Mirena IUS and experienced
- discomfort
- unacceptable symptoms
- troublesome (symptomatic) ovarian cysts
- Loss of periods is unacceptable to the woman but heavy periods precludes use of copper IUD.
- History of breast cancer (for consultation at specialist contraception clinic and following involvement of oncologist)
- Woman wishes to avoid hormones because of unacceptable side effects with hormones previously.
- Failure at time of fitting to dilate internal os sufficiently for Mirena Jaydess IUS may be fitted because of narrower diameter.
APCO March 2018
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07.03.03 |
Spermicidal contraceptives |
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07.03.04 |
Contraceptive devices |
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07.03.04 |
Intra-uterine devices |
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Intra-uterine Contraceptive Devices
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Formulary
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Funded by Public Health - as per Family Planing Association Guidelines.
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Intra-uterine Contraceptive Devices (Flexi-T® + 300)
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Formulary
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Funded by Public Health - as per Family Planing Association Guidelines.
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Intra-uterine Contraceptive Devices (Flexi-T® 300)
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Formulary
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Funded by Public Health - as per Family Planing Association Guidelines.
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Intra-uterine Contraceptive Devices (GyneFix®)
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Formulary
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Funded by Public Health - as per Family Planing Association Guidelines.
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Intra-uterine Contraceptive Devices (Load® 375)
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Formulary
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Funded by Public Health - as per Family Planing Association Guidelines.
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Intra-uterine Contraceptive Devices (Nova-T® 360)
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Formulary
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Funded by Public Health - as per Family Planing Association Guidelines.
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Intra-uterine Contraceptive Devices (T-Safe® CU 380 A)
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Formulary
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Funded by Public Health - as per Family Planing Association Guidelines.
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Intra-uterine Contraceptive Devices (TT 380 Slimline®)
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Formulary
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Funded by Public Health - as per Family Planing Association Guidelines.
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Intra-uterine Contraceptive Devices (UT 380 Short®)
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Formulary
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Funded by Public Health - as per Family Planing Association Guidelines.
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Intra-uterine Contraceptive Devices (UT 380 Standard®)
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Formulary
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Funded by Public Health - as per Family Planing Association Guidelines.
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07.03.05 |
Emergency Contraception |
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07.03.05 |
Hormonal methods |
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Levonogrestrel (Levonelle® 1500)
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First Choice
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Levonelle® remains the first line choice of emergency contraception in patients. Available in certain pharmacies following consultation with a pharmacist.
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Ulipristal (EllaOne®) (Emergency contraception)
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Restricted
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For use as emergency contraception for patients 72-120 hours post unprotected intercourse and when an intra-uterine device is not appropriate. APCO November 2009.
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07.04 |
Drugs for genito-urinary disorders |
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07.04.01 |
Drugs for urinary retention |
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Tamsulosin Hydrochloride (Modified-release capsules)
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First Choice
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For benign prostatic hyperplasia.
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Indoramin (Doralese®)
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Formulary
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Please note that Tamsulosin M/R capsules are first line.
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Prazosin
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Formulary
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Please note that Tamsulosin M/R capsules are first line.
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07.04.01 |
Parasympathomimetics |
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Bethanechol Chloride (Myotonine®)
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Formulary
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07.04.01.02 |
5-Alpha reductase inhibitors |
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07.04.02 |
Drugs for urinary frequency, enuresis, and incontinence |
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07.04.02 |
Urinary incontinence |
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Tolterodine (Standard-release tablets)
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First Choice
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First-line choice in line with The Management of Over Active Bladder Syndrome Guidelines. APCO March 2017.
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OCCG Leaflet: Patient information on trial of stopping overactive bladder drug
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Fesoterodine (Toviaz®) (Modified-release tablets)
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Second Choice
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Second-line option if tolterodine tolerated but not effective and mirabegron is contra-indicatedin line with The Management of Over Active Bladder Syndrome Guidelines. APCO March 2017.
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OCCG Leaflet: Patient information on trial of stopping overactive bladder drug
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Mirabegron (Betmiga®)
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Second Choice
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In line with The Management of Over Active Bladder Syndrome Guidelines. - Second-line option if antimuscarinic drugs are contra-indicated
- Third-line option if antimuscarinic drugs have not been effective and mirabegron is not contra-indicated
NB. Mirabegron is contraindicated in patients with severe uncontrolled hypertension (systolic blood pressure ≥180 mm Hg or diastolic blood pressure ≥110 mm Hg, or both). Blood pressure should be measured before starting treatment and monitored regularly during treatment, especially in patients with hypertension. MHRA Oct 2015. APCO March 2017.
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MHRA: Risk of severe hypertension and associated CV events with mirabegron
NICE TA290: Mirabegron for overactive bladder
OCCG Leaflet: Patient information on trial of stopping overactive bladder drug
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Oxybutynin (Tablet)
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Restricted
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Oxybutynin should not be initiated for new patients. People whose treatment with oxybutynin is not recommended in The Management of Over Active Bladder Syndrome Guidelines, but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop. APCO March 2017.
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Medicines for Children leaflet: Oxybutynin for daytime urinary symptoms
OCCG Leaflet: Patient information on trial of stopping overactive bladder drug
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Oxybutynin Hydrochloride (Kentera®) (Patch)
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Restricted
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Restricted for patients with swallowing difficulties in line with The Management of Over Active Bladder Syndrome Guidelines. APCO March 2017.
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Solifenacin (Vesicare®)
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Formulary
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Suitable for continuation in primary care following specialist initiation for paediatric patients with overactive bladder (tablets and liquid).
Approved subject to MMTC. Tablets are not licensed for use in children but licensed in adults for symptomatic treatment of urge incontinence and/or increased urinary frequency and urgency. The liquid is licensed for neurogenic detrusor overactivity (NDO) in paediatric patients aged 2 to 18 years. In paediatric patients it is currently used by the specialist team as second/third line therapy following failure of either oxybutynin or tolterodine.
APCO November 2019.
Solifenacin should not be initiated for new adult patients.
People whose treatment with solifenacin is not recommended in The Management of Over Active Bladder Syndrome Guidelines, but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.
Review continued benefit of antimuscarinic therapy and consider switching to tolterodine if this has not previously been tried.
APCO March 2017.
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Trospium
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Restricted
|
Patients currently taking trospium should be allowed to continue with this treatment. Trospium may be an appropriate choice for patients taking multiple concomitant therapies as it does not interact with drugs metabolised by CYP 450 liver enzymes in line with The Management of Over Active Bladder Syndrome Guidelines. APCO March 2017.
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Botulinum Toxin A (Overactive bladder)
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Formulary
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In line with Clinical Commissioning Policy 254A.
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Duloxetine
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Formulary
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For stress incontinence following recommendation from specialists only. Duloxetine should not be prescribed for overactive bladder. APCO July 2006.
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07.04.02 |
Nocturnal enuresis |
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07.04.02 |
beta3-adrenoceptor agonists |
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07.04.03 |
Drugs used in urological pain |
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Pentosan polysulfate sodium (Elmiron®)
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Formulary
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Specialist use only for treating bladder pain syndrome in line with NICE TA610.
APCO January 2020.
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NICE TA610: Pentosan polysulfate sodium for treating bladder pain syndrome
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07.04.03 |
Alkalinisation of urine |
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Potassium Citrate
|
Formulary
|
Available to purchase over-the-counter for the relief of discomfort in mild urinary-tract infections.
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Sodium Citrate
|
Formulary
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Available to purchase over-the-counter for the relief of discomfort in mild urinary-tract infections.
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07.04.03 |
Acidification of urine |
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07.04.03 |
Other preparations for urinary disorders |
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07.04.04 |
Bladder instillations and urological surgery |
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Dimethyl Sulphoxide Bladder Instillation 50% (DMSO)
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Unlicensed
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Secondary care use only for symptomatic relief in patients with interstitial cystitis (Hunner's ulcer).
|
Nice Evidence Summary: Interstitial cystitis - dimethyl sulfoxide bladder instillation
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07.04.04 |
Urological surgery |
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Glycine 1.5% (Irrigation solution)
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Formulary
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Secondary care use only.
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07.04.04 |
Maintenance of indwelling urinary catheters |
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Catheter Patency Solutions (Chlorhexidine 0.02%)
|
Formulary
|
Brands include Uro-Tainer Chlorhexidine®.
|
MHRA alert: Anaphylaxis risk with chlorhexidine
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Catheter Patency Solutions (Sodium chloride 0.9%)
|
Formulary
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Catheter Patency Solutions (Solution R)
|
Formulary
|
Contains Citric acid 6%, gluconolactone 0.6%, magnesium carbonate 2.8% and disodium edetate 0.01%. Brands include OptiFlo R®, Uriflex R®, and Uro-Tainer® Twin Solutio R.
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07.04.05 |
Drugs for erectile dysfunction |
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Alprostadil (Caverject®)
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Restricted
|
For erectile dysfuction in line with Clinical Commissioning Policy 41F.
APCO May 2016.
For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.
APCO November 2012.
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Alprostadil (MUSE®)
|
Restricted
|
For erectile dysfuction in line with Clinical Commissioning Policy 41F.
APCO May 2016.
For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.
APCO November 2012.
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Alprostadil (Viridal® Duo)
|
Restricted
|
For erectile dysfuction in line with Clinical Commissioning Policy 41F.
APCO May 2016.
For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.
APCO November 2012.
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07.04.05 |
Phosphodiesterase type 5 inhibitors |
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Sildenafil
|
Restricted
|
First line treatment for erectile dysfunction. SLS restrictions removed for generic sildenafil. The quantity prescribed for erectile dysfunction should be limited to 4 doses per month in line with Clinical Commissioning Policy 41F.
APCO May 2016.
For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.
|
Generic sildenafil (QIPP) information
Generic sildenafil (QIPP) information supporting information
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Avanafil (Spedra®)
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Restricted
|
For erectile dysfunction in line with Clinical Commissioning Policy 41F.
APCO May 2016.
For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.
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Tadalafil
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Restricted
|
For erectile dysfunction in line with Clinical Commissioning Policy 41F.
APCO May 2016.
For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.
For symptoms associated with benign prostatic hyperplasia in line with NICE TA273.
APCO March 2013.
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NICE TA273: Hyperplasia (benign prostatic) - tadalafil (terminated appraisal)
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Vardenafil (Levitra®)
|
Restricted
|
For erectile dysfunction in line with Clinical Commissioning Policy 41F.
APCO May 2016.
For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.
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|
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07.04.05 |
Papaverine and phentolamine |
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Aviptadil + phentolamine (Invicorp®)
|
Restricted
|
Second line treatment for erectile dysfunction equal to Caverject after oral therapies in line with Clinical Commissioning Policy 41F.
APCO July 2018.
For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.
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Papaverine
|
Formulary
|
Secondary care use only. Unlicensed indication. Patients with neurological or psychogenic impotence are more sensitive to the effect of papaverine than those with vascular abnormalities.
|
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Phentolamine (Erectile dysfunction)
|
Formulary
|
Secondary care use only. Unlicensed indication.
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|
07.04.06 |
Drugs for premature ejaculation |
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07.05 |
Drugs used in Gynaecology endocrinology |
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|
07.05.01 |
For ovulation induction |
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|
07.05.01.01 |
Anti-oestrogens |
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07.05.01.02 |
Gonadotrophins |
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07.05.03 |
For ovulation trigger |
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07.05.04 |
For withdrawal bleeding |
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.... |
Non Formulary Items |
Alfuzosin (Modified-release tablets)

|
Non Formulary
|
Please note that Tamsulosin M/R capsules are first line. APCO July 2006. |
|
Alfuzosin (Standard-release tablets)

|
Non Formulary
|
Please note that Tamsulosin M/R capsules are first line. Not recommended for urinary retention in children due to lack of evidence. APCO July 2006. |
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Alprostadil (Prostin VR®)

|
Non Formulary
|
|
|
Alprostadil 3mg/g cream (Vitaros®) (Erectile dysfunction)

|
Non Formulary
|
Not recommended for erectile dysfunction due to limited evidence and clinical and cost effectiveness, in line with Clinical Commissioning Policy 41F.
APCO May 2016.
|
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Anethol, Borneol, Camphene, Cineole, Fenchone, Pinene (Rowatinex®)

|
Non Formulary
|
A terpene mixture claimed to be of benefit in urolithiasis for the expulsion of calculi. |
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Atosiban

|
Non Formulary
|
|
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BARD Catheter Trays

|
Non Formulary
|
Not recommended for use as more expensive than components. More cost effective alternatives are available. APCO January 2014. |
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Carbetocin (Pabel®)

|
Non Formulary
|
|
|
Catheter Patency Solutions (Solution G)

|
Non Formulary
|
|
|
Combined Hormonal Contraceptives (BiNovum®)

|
Non Formulary
|
|
|
Combined Hormonal Contraceptives (Femodene® ED)

|
Non Formulary
|
Microgynon 30 ED® is more cost-effective than Femodene ED®. |
|
Combined Hormonal Contraceptives (Minulet®)

|
Non Formulary
|
|
|
Combined Hormonal Contraceptives (Qlaira®)

|
Non Formulary
|
No evidence of clinical benefit over other more cost effective alternatives. No long term safety data. APCO July 2011. |
|
Combined Hormonal Contraceptives (Triadene®)

|
Non Formulary
|
Logynon®, TriRegol® and Synphase® are more cost-effective. |
|
Combined Hormonal Contraceptives (Tri-minulet®)

|
Non Formulary
|
|
|
Combined Hormonal Contraceptives (TriNovum®)

|
Non Formulary
|
|
|
Dapoxetine (Priligy®)

|
Non Formulary
|
Not recommended for premature ejaculation.
APCO March 2014. |
|
Darifenacin (Emselex®)

|
Non Formulary
|
Not recommended for use. APCO May 2011. |
|
Dinoprostone (Propess® 10mg)

|
Non Formulary
|
|
|
Distigmine Bromide (Ubretid®)

|
Non Formulary
|
|
|
Doxazosin

|
Non Formulary
|
Not recommended for benign prostatic hypertropphy. APCO September 2009. |
UKMI Q&A: How should conversion between doxazosin formulations be carried out?
UKMI Q&A: What is the evidence comparing doxazosin XL with standard doxazosin?
|
Dutasteride and Tamsulosin (Combodart®)

|
Non Formulary
|
No evidence of advantage over finasteride or that patients failing on finasteride will benefit from dutasteride. APCO September 2011. |
|
Econazole (Gyno-Pevaryl®)

|
Non Formulary
|
|
|
Ethinylestradiol 20 mcg / drospirenone 3 mg (Eloine®)

|
Non Formulary
|
Not cost-effective. |
|
Ethinylestradiol 20 mcg / norethisterone 1mg (Loestrin 20®)

|
Non Formulary
|
Discontinued by manufacturer |
|
Ethinylestradiol 30mcg / norethisterone 1.5mg (Loestrin 30®)

|
Non Formulary
|
Discontinued by manufacturer |
|
Etonorgestrel (Implanon®)

|
Non Formulary
|
Discontinued in October 2010 and replaced by Nexplanon®, but some women may have the implant in place until 2013. |
|
Fenticonazole (Gynoxin®)

|
Non Formulary
|
|
|
Flavoxate (Urispas 200®)

|
Non Formulary
|
|
|
Gemeprost

|
Non Formulary
|
|
|
Imipramine

|
Non Formulary
|
|
|
Intra-uterine Progestogen Only System (Kyleena®) (Levonorgestrel 19.5 mg)

|
Non Formulary
|
Contraception for up to 5 years. Not part of OCC contraception service.
APCO July 2018. |
|
Ketoconazole 2% (Nizoral®) (Vaginal cream)

|
Non Formulary
|
|
|
Lactic acid (Balance Activ Rx®)

|
Non Formulary
|
|
|
Lactic Acid (Relactagel®)

|
Non Formulary
|
|
|
Misoprostol (Gynae)

|
Non Formulary
|
Unlicensed use. |
|
Misoprostol vaginal delivery system (Mysodelle®)

|
Non Formulary
|
For induction of labour. |
|
Nomegestrol acetate and beta estradiol (Zoely®)

|
Non Formulary
|
Not recommended as there are more cost effective alternatives available. APCO May 2013. |
|
Norethisterone (Micronor®) (Oral progestogen-only contraceptive)

|
Non Formulary
|
Discontinued 2017. |
|
Norethisterone enantate (Noristerat®)

|
Non Formulary
|
Provides contraception for 8 weeks; it is used as short-term interim contraception e.g. before vasectomy becomes effective. |
|
Nystatin (Vaginal candidiasis)

|
Non Formulary
|
Nystatin pessaries and nystatin vaginal cream have been discontinued. |
|
Oestrogens, Topical (Ortho-Gynest®)

|
Non Formulary
|
|
|
Ospemifene (Senshio®)

|
Non Formulary
|
|
|
Oxybutynin Intra-vesical (5mg/30ml)

|
Non Formulary
|
|
|
Penile implant

|
Non Formulary
|
For erectile dysfuction in line with Clinical Commissioning Policy 41F.
APCO May 2016. |
|
Propantheline

|
Non Formulary
|
There is no evidence to support the efficacy of propantheline and it should not be used. See The Management of Over Active Bladder Syndrome Guidelines. APCO March 2015. |
|
Propiverine (Detrunorm®)

|
Non Formulary
|
Not recommended for use. APCO May 2011. |
|
Replens MD®

|
Non Formulary
|
|
|
Ritodrine (Yutopar®)

|
Non Formulary
|
|
|
Sodium Citrate 3% (Irrigation solution)

|
Non Formulary
|
|
|
Solifenacin and Tamsulosin (Vesomni®)

|
Non Formulary
|
Not recommended due to lack of evidence. APCO September 2014. |
|
Spremicidal Contraceptives (Ortho-Creme®)

|
Non Formulary
|
|
|
Spremicidal Contraceptives (Orthoforms®)

|
Non Formulary
|
|
|
Sylk® (Paraben-free personal lubricant)

|
Non Formulary
|
In line with Clinical Commissioning Policy 88D. Can be purchased over the counter.
APCO January 2011. |
|
Tadalafil (Cialis®)

|
Non Formulary
|
|
|
Tadalafil once daily

|
Non Formulary
|
Not recommended as no head-to-head trials to compare efficacy or new safety issues. APCO March 2009. |
|
Tamsulosin Hydrochloride (Modified-release tablets)

|
Non Formulary
|
Please note that Tamsulosin M/R capsules are first line. APCO September 2011. |
|
Terazosin

|
Non Formulary
|
Please note that Tamsulosin M/R capsules are first line. |
|
Tolterodine (Modified-release capsules)

|
Non Formulary
|
Standard-release tablets are first-line for overactive bladder treatment. See The Management of Over Active Bladder Syndrome Guidelines. APCO March 2017. |
|
Vacuum pumps

|
Non Formulary
|
For erectile dysfuction in line with Clinical Commissioning Policy 41F.
APCO May 2016.
For penile rehabilitation following prostate surgery in line with Clinical Commissioning Policy 233C.
APCO November 2012. |
|
Yes® water-based intimate lubricant

|
Non Formulary
|
In line with Clinical Commissioning Policy 88D. Can be purchased over the counter.
APCO July 2014. |
|
|
Key |
|
|
Cytotoxic Drug
|
|
Controlled Drug
|
|
High Cost Medicine
|
|
Cancer Drugs Fund
|
|
NHS England |
|
Homecare |
|
CCG |
|
Traffic Light Status Information
Status |
Description |

|
Red: Medicines which should only be prescribed in secondary care by a specialist. |

|
Amber Continuation: Medicines which should be initiated or recommended by a specialist for continuation in primary care. The specialist must notify the GP that the prescribing responsibility has been transferred. |

|
Amber Shared Care Protocol: Medicines which are appropriate to be initiated and stabilised by a specialist, once stabilised the medicine may be appropriate for responsibility to be transferred from secondary to primary care with the agreement of a GP and a formal ‘shared care’ agreement. The shared care protocol must be approved by the Area Prescribing Committee Oxfordshire (APCO). |

|
Green: Medicines which are suitable for initiation and ongoing prescribing within primary care. |

|
Brown: Medicines which should only be prescribed in restricted circumstances. |

|
Black: Medicines which are not recommended for use because of lack of evidence of clinical effectiveness, cost effectiveness or safety. |

|
not used |
|
|
|